Provider Demographics
NPI:1902995699
Name:CITY MEDICAL NURSING CENTER LLC
Entity Type:Organization
Organization Name:CITY MEDICAL NURSING CENTER LLC
Other - Org Name:CITY MEDICAL HOME HEALTH NURSING SERVICESLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:FELIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-759-1191
Mailing Address - Street 1:5340 E MAIN ST
Mailing Address - Street 2:SUITE # 212
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43213-2574
Mailing Address - Country:US
Mailing Address - Phone:614-759-1191
Mailing Address - Fax:614-759-1391
Practice Address - Street 1:5340 E MAIN ST
Practice Address - Street 2:SUITE # 212
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2574
Practice Address - Country:US
Practice Address - Phone:614-759-1191
Practice Address - Fax:614-759-1391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2012-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH368065251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH368065Medicare Oscar/Certification